History Is Made
During the final stretch leading up to the House's historic vote on health care reform, Representative John Lewis said: "We may not have chosen the time, but time has chosen us." Speaker Nancy Pelosi repeated these words when she closed the debate. She then used a phrase that I have been fond of saying for about thirty years: 'health care is a right, not a privilege.' And tonight, the House took major (if still not-quite-sufficient steps) toward making this phrase mean something in our country.
As the President said in remarks delivered after the House vote: “This is not radical reform, but it is major reform.” Okay, I would have preferred something more radical (more significantly reducing the role of private health insurance companies, for example, and getting everyone covered a lot sooner). As major legislation goes, it's on the moderate side. But, given the tenor of the debate leading up to this vote, the way in which the Republicans made this about the role of government (with government as the 'bad guys'), it's passage could have more far-reaching ideological implications (as in, we can get the upper hand in the larger debate about the role of government, working with citizens' groups to improve peoples' lives). Meanwhile, there are several good features in this legislation that everyone in the country needs to know about. Such as the following:
1. Children under age of 19 may not be excluded for pre-existing conditions. Also, families can opt to keep young adult dependents on their policies through the age of 26 (a provision that reminds me I was one month away from being dropped from my parents' insurance when I had a major bike accident).
2. Almost immediately, uninsured adults with pre-existing conditions will be able to buy into a national high-risk pool. (For many, though, the costs may still be prohibitive; they will have to wait until the exchanges come online in 2014 for more affordable options).By 2014, insurance companies will have to accept people with pre-existing conditions.
3. It eliminates lifetime or annual caps on coverage (something that benefits everyone, almost immediately). One less thing to worry about.
4. It closes the dreaded “donut hole.” Currently, Medicare Part D covers up to $2,700 per year in prescription drug payments, then stops. Coverage kicks in again if/when the patient’s drug costs exceed $6,100. 3.4 million seniors are caught in this gap, struggling to keep up with their medications. The new law shrinks, and over time, eliminates the donut hole.
5. Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50% of what they pay for employees’ health insurance.
6. The law requires all insurers to post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments. (Hmmm. This would be a good requirement for the big banks,too).
7. Having worked in a community health center in the 1980s, I especially like this provision: funding will increase immediately for community health centers that provide primary, dental, vision and mental health services to members of their communities. Community-run, not-for-profit centers provide quality services on a sliding fee scale. Unlike larger, impersonal hospital clinics, community health centers get to know the people they serve, and often are governed by people in the community. I worked for a clinic in the Lower East Side that almost had to shut down because of federal funding cuts. Now, this and similar clinics will get the support they need so that community members can get personalized, continuous and coordinated primary care.
There is reason for hope, as well as room for improvement. Perhaps the most immediate, and politically significant impact of the House vote is that we may have turned a corner away from deadlock toward much-needed action on jobs, financial reform, immigration reform, climate issues, and more. Could the Democrats keep this momentum going? And are there any moderate Republicans left who are willing to step up?
---Sandra Hinson
